Form Orthotics & Prosthetics, Pllc
Prosthetic & Orthotic Supplier
4921 E State St Lowr Level, Rockford
Illinois, 61108-2275
402-212-7878 Maps & DirectionsForm Orthotics & Prosthetics, Pllc is a Prosthetic & Orthotic Supplier in Rockford, Illinois. It is situated at 4921 E State St Lowr Level, Rockford and its contact number is 402-212-7878. The authorized person of Form Orthotics & Prosthetics, Pllc is Micah Alford
who is Founder of the store and his/her contact number is 402-212-7878.
Form Orthotics & Prosthetics, Pllc is an organization that provides prosthetic and orthotic care which may include, but is not limited to, patient evaluation, prosthesis or orthosis design, fabrication, fitting and modification to treat limb loss for purposes of restoring physiological function and/or cosmesis or to treat a neuromusculoskeletal disorder or acquired condition.
Complete Profile:
Form Orthotics & Prosthetics, Pllc Center speciality, address, contact phone number and fax are as below.
Patients can directly walkin to the Prosthetic/Orthotic center or can call on the below given phone number for appointment.
| Specialization: | Prosthetic & Orthotic Supplier |
| Address: | 4921 E State St Lowr Level, Rockford, Illinois, 61108-2275 |
| Phone: | 402-212-7878 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints of this store are as below. Person's position and contact details are also mentioned below.
| Name: | Micah Alford |
| Position: | Founder |
| Contact Number: | 402-212-7878 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Form Orthotics & Prosthetics, Pllc center are as mentioned below.
| NPI Number: | 1740113422 |
| NPI Enumeration Date: | 04 Jun, 2026 |
| NPI Last Update On: | 04 Jun, 2026 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Form Orthotics & Prosthetics, Pllc are as mentioned below.
| Specialization | License Number | State | Status | |
| Prosthetic/orthotic Supplier | | | Primary | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Form Orthotics & Prosthetics, Pllc 4921 E State St Lowr Level, Rockford, Illinois |
| Zip: | 61108-2275 |
| Phone Number: | -- |
Patients can reach Form Orthotics & Prosthetics, Pllc at
4921 E State St Lowr Level, Rockford, Illinois or can
call to book an appointment on 402-212-7878.
Comments/ Reviews:
Patients can read all the reviews posted for Form Orthotics & Prosthetics, Pllc below. You may also share your own experience like the quality of treatment, behavior, and overall care provided by Form Orthotics & Prosthetics, Pllc. It will help others make informed decisions.
** Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 08 June, 2026.